Aly Goldfarb Paquette, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

1551 Renaissance Towne Dr Ste 400
Bountiful, UT 84010-7676

Phone

(801) 295-7200

NPI assigned

Mar 13, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1982145710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR STE 400",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107676",
            "telephone_number": "801-295-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 RENAISSANCE TOWNE DR STE 400",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107676",
            "telephone_number": "801-295-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAQUETTE",
        "first_name": "ALY",
        "middle_name": "GOLDFARB",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-13",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Francis Page, DDS
• Tiffany M Page, ACMHC
• Ivy J Palfreyman, RBT
• Brent A Palmer, D.M.D.
• Nancy Narrod Pantziris, M.D.
• Zaylie Paras
• Vanessa Katherine Paredez, DMD
• Emmaline Esther Park
• Jay D Parker, OTR L
• Makayla Dee Parker

• Surgical Physician Assistant in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Surgical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.